Strengthening systems, saving lives

In the remote highlands of Thaba-Tseka, where the terrain is steep and the winters unforgiving, Nurse Palesa Motšoari begins each morning with a backpack full of vaccines and a heart full of determination. Her mission is simple but not easy: to bring life-saving immunizations to children in some of Lesotho’s most isolated villages—regardless of how far, how cold, or how long the journey. 

Until recently, delivering vaccines in the district was filled with uncertainty. Fridges were squeezed into shared offices, a single vehicle covered the entire area, and power cuts—planned and unplanned—risked compromising vaccine potency overnight. 

“Sometimes mothers would walk for hours, only to be turned away,” says Dr. Mashale Joseph, the District Medical Officer. “But change is beginning to take root. With stronger infrastructure and more dependable support, it’s becoming easier for families to find vaccines when they need them. Fewer children are being missed. That means more children are growing up protected.”

Change is beginning to take root thanks to an intervention by UNICEF Lesotho with generous support from the Government of Japan. A new vaccine store, built to WHO standards, has been completed in Thaba-Tseka. Unlike the cramped rooms of the past, this 180-square-meter facility is purpose-built: it features temperature-regulated cold chain equipment, backup solar and generator power, and dedicated space for vaccine handling and management. For the first time, the district will have its own reliable, independent vaccine storage.

With this infrastructure in place, delays and stockouts are expected to significantly decrease. Health workers will no longer depend on a single vehicle or on electricity alone. Outreach efforts will be easier to plan and more consistent to carry out. The result will be fewer children left behind—fewer missed appointments, fewer dropouts, and a stronger push to reach every child with life-saving vaccines. 

Still, physical infrastructure is only part of the solution. In a country where much of the population lives far from health facilities, Community Health Workers (CHWs) have long served as the vital link between the system and the people. They walk across mountains, visit households, deliver immunizations, and follow up with new mothers and their babies. But for years, their impact was limited by something less visible: a lack of reliable data. 

Before now, the Ministry of Health had no real-time way to track where CHWs were working, what services they were providing, or which communities remained unreached. Information was stored on paper at health posts or filed away in district offices, making it hard to plan, respond, or support CHWs effectively.

This is now changing. With support from the same Japan-funded initiative, the Ministry of Health and UNICEF Lesotho have introduced a digital breakthrough—the Geo-referenced Community Health Worker Master List. Using mobile devices, CHWs now log their activities and locations into an integrated digital system, creating a live map of service coverage across the country. 

This master list connects directly to Lesotho’s national Health Management Information System (HMIS), enabling faster decisions and better resource allocation. Training, supervision, supply management, even payroll—all are now linked to real-time data, finally giving health planners a full picture of who is doing what, where, and when. 

Hope is indeed what defines this moment in Thaba-Tseka. Though some aspects—like decentralized training and maintenance—are still works in progress, the foundations for long-term system resilience are being laid. The cold chain is stronger. The data is smarter. The workers are better equipped. 

Most of all, the people feel seen. 

“We truly appreciate this support,” says Dr. Mashale Joseph. “It’s going to transform the way we deliver immunizations. Thaba-Tseka will now be part of the national solution.” For ‘M’e Lineo, a mother of three who used to walk half a day to reach the clinic, this progress is deeply personal. 

“I just want my children to be safe,” she says, holding her youngest close. “And now, I believe they will be. Because the vaccines will be there when we need them.” 

In a place where cold once meant risk and isolation, vaccines are now kept safe and steady—powered by solar energy, guided by digital maps, and carried forward by the unwavering hands of health workers. With each drop of vaccine delivered, a stronger, fairer health system is coming to life—one child, one nurse, one village at a time.